Family planning programmes and the reduction of fertility: lessons learned

Family planning is most inexpensive intervention to empower poor women of the world to exercise their rights to better sexual and reproductive health. Despite the dramatic increase in contraceptive use in last four decades, in many populations still the unmet need remains high due to lack of Government commitment and poor accessibility of contraception. The main objective of this paper is to understand the levels and trends in unmet need for family planning and contraceptive prevalence rate (CPR) among poor and non-poor. Further, changes in overall fertility and fertility preferences among poor and non-poor in selected Asian countries namely: Bangladesh, India, Indonesia, Nepal, Philippines and Vietnam. Three rounds of most recent DHS data for each country (except Vietnam) have been analyzed for the study. Selected Asian countries are in different stages of fertility as well as family planning transition. Preliminary results suggest that, unmet need as well as TFR is comparatively higher among poor women compared to their non-poor counterparts. It is also observed that TFR, mean ideal family size and desire for additional child have declined irrespective of economic status over time probably due to the increasing CPR and diffusion of idea of perceived benefits of small family size.

Over the last fifty years, the Algerian case shows that contradiction always existed between the fertility trends and governmental policies. Despite the demographic explosion of the 1960s (with a natural growth rate above 3%), Algerian authorities claimed a hostile attitude towards the very idea of family planning, considered as “imperialist”. Nevertheless, fertility began to decline as soon as the mid-1970s, well before the government attitude suddenly reversed and the first family planning program was introduced in 1983. From 8 children per woman in 1970 fertility felt to 5.3 in 1982. Indeed, since 1983 fertility decline accelerated to reach 2.2 in 2002, but data analysis revel a rather tedious relation with the implementation of the family planning program. Finally, in spite of a new reinforcement of this program, Algerian fertility suddenly rose up to 2.9 in 2010. A new evidence that family planning program is not enough to achieve fertility goals.